DATHATREYA KANDAGARI Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070019837

License Status

NOT RENEWED

Business

First Name

DATHATREYA

Last Name

KANDAGARI

Business Name

DATHATREYA KANDAGARI

Original Issue Date

05/20/2013

Effective Date

09/23/2016

Expiration Date

09/30/2018

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

12/05/2018